FORM 1023-EZ for NEW MEXICO ADAPTIVE

Field Data
EIN 82-4683367
Case Number EO-2020023-000492
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NEW MEXICO ADAPTIVE
Organization’s Mailing Address 1612 ALAMO AVE SE
City ALBUQUERQUE
State NM
ZIP 87106
Accounting period End 12
Primary contact name JUANITA JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOMINIQUE ROGERS
PRESIDENT
1612 ALAMO SE
ALBUQUERQUE NM 87106

Officer/Director/Trustee Two

DAVID GONZALES JR
VICE PRESIDENT
609 3RD STREET NE
RIO RANCHO NM 87124

Officer/Director/Trustee Three

JOSE CABRERA
SECRETARY TREASURER
1309 VILLA CHAMISA NE
ALBUQUERRQUE NM 87109

Officer/Director/Trustee Four

MELANIE BRIONEZ
EXECUTIVE ASSISTANT
262 GENE AVE NW
ALBUQUERQUE NM 87107

Organization’s website
Organization’s email NMADAPTIVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2018
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DOMINIQUE ROGERS
Signature Title PRESIDENT
Signature Date 1/21/2020

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